寒冷的荨麻疹在医生的实践

A. Bogomolov
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引用次数: 0

摘要

目的:提高对感冒性荨麻疹的鉴别诊断和治疗方法。材料和方法。本文对文献进行了回顾,并对感冒性荨麻疹患者的诊断方法和治疗原则进行了分析。结果和讨论。寒性荨麻疹的特征是瘙痒、血管神经性水肿或两者兼而有之,伴或不伴皮肤和/或粘膜冷却后发生的过敏反应。据估计,寒冷性荨麻疹的发病率为0.05%,在寒冷气候中发病率更高。人们认为荨麻疹的症状主要与皮肤肥大细胞的活化有关。然而,近年来出现的数据强调了血液凝固在疾病病理生理中的可能作用。在一些患者中,在对寒冷因素,特别是冷空气作出反应而发生寒性荨麻疹的同时,可能会出现临床上类似于鼻窦炎、结膜炎和支气管哮喘的反应,尽管它可能与其他类型的荨麻疹并存。荨麻疹患者治疗的主要原则是:查明致病因素,对患者进行教育和预防与致病因素接触,逐步进行药物治疗。结论。寒性荨麻疹是慢性过敏性荨麻疹的一种亚型,具有这类异质性疾病的所有特征,但在发病机制和真正的流行病学方面仍然知之甚少。消除措施、患者教育和根据现有算法进行治疗可以显著提高患者的生活质量,这是治疗任何慢性疾病的重中之重。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cold urticaria in the doctor’s practice
Objective — to improve the methods of differential diagnosis and management of patients with cold urticaria. Materials and methods. A review of the literature is presented and diagnostic approaches and principles of management of patients with cold urticaria are analyzed. Results and discussion. Cold urticaria is characterized by itching, angioneurotic edema, or both, with or without anaphylaxis which occurs in response to cooling of the skin and/or mucous membranes. The incidence of cold urticaria is estimated at 0.05 %, with higher rates in cold climates. It is believed that the symptoms of urticaria are primarily related to the activation of mast cells in the skin. However, in recent years, data have emerged highlighting the possible role of blood coagulation in the pathophysiology of the disease. In some patients, in parallel with the development of cold urticaria in response to cold factors, especially cold air, there may be reactions that are clinically similar to sinusitis, conjunctivitis and bronchial asthma, although it may coexist with other types of urticaria. The main principles of treatment of patients with urticaria are: identification of causative factors, education of patients and prevention of contact with causative factors, and stepwise pharmacotherapy. Conclusions. Cold urticaria is a subtype of chronic induced urticaria that has all the features of this heterogeneous group of diseases, but is still poorly understood in terms of both pathogenesis and real epidemiology. Elimination measures, patient education and treatment according to existing algorithms can significantly improve the quality of life of patients, which is a priority for the treatment of any chronic disease.
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